ALLERGY: FOOD AND DRINK
The topic of food sensitivity – of allergy or intolerance to food and drink – is probably the most difficult area of this book. Not only is the subject the most controversial and the one which arouses most hostility from sceptics, but it is also the most demanding area to manage if you are trying to discover what upsets you. Futhermore, food sensitivity is one of the most difficult types of allergy or sensitivity to live with. Avoiding certain foods can affect your family life profoundly, particularly if children are involved. It impinges on your social life and your worklife, and engages you frequently on complicated endeavours of organisation and planning.
Working out a diet that suits you can often be a quite straightforward process if you go about it in an orderly fashion. The vast majority of people find that they can solve their problems by avoiding just one or a tiny number of foods – even if it takes them some time to work out which ones.
However, a small handful of people have much more severe problems, discovering that they are sensitive to a wide range of foods. Often such people do not suspect wide-ranging sensitivity before embarking, and only discover it in the process of eliminating and testing foods.
It is best to do any exclusion dieting under medical supervision, because the process of identifying food allergy and intolerance can occasionally be complicated, because some (rare) individuals can become quite ill in the process of sorting out their diet, and because specialist advice on nutritional balance is often necessary. This is especially important if you are working out a diet for a baby or child.
Some doctors, however, are unsympathetic or even hostile to the idea of reactions to food. Many GPs will not consider giving you any help in the process, let alone refer you to someone else who can help. If you meet this reaction from your doctor, remember that it is worth persisting in asking for a referral to a specialist. Your doctor may eventually agree, if only because he or she believes it will exclude food allergy or intolerance as a possible cause of your symptoms. You have also the right to change your doctor without giving a reason and, if you meet with real hostility, it may be necessary to do this. For how to find doctors who specialise in the field.
If, despite all your efforts, you cannot get satisfactory help from a doctor, you may decide to carry through a limited exclusion diet by yourself. If you do so, go gently. You should only exclude foods selectively, rather than go for a comprehensive exclusion diet (see below for full advice), and take your time, rather than to try to identify problem foods quickly. Never go on a fast or a one- or two-food-diet without supervision.
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ALLERGY: FOODS
Opinion among doctors and experts as to the degree of cross-reaction between foods varies widely; you will often encounter differing (sometimes conflicting) advice on which foods cross-react.
Foods, as all living things, are classified biologically into groups and sub-groups according to their inter-relationships. These categories include ‘family’ and ‘sub-family’ groupings. It is argued that cross-reaction is more likely to occur within a food family, and diets may be planned and managed on this basis. If you are on a rotation diet, for instance, you will often be advised to leave an interval of two days or more between eating foods that belong to the same family. This can be quite restrictive.
In practice, the family model is not always helpful. Some families, such as the legume family, which includes peas, beans, pulses and peanuts, are very broad. Some foods within such a family are very distantly related, and cross-reaction can be rare. Sometimes cross-reaction only occurs consistently within sub-families. The grass family includes the wheat sub-family, the corn sub-family, and the rice subfamily, and cross-reaction often occurs within the sub-families, but less commonly between them. If you react to wheat, for example, you are more likely to cross-react to oats, which is part of its sub-family, than to rice, which is related but belongs to a separate sub-family.
Like many aspects of allergy and sensitivity, the cross-reaction of foods can be very confusing, and you will probably have to work out for yourself, with expert guidance, what you tolerate and what causes cross-reaction in you.
The best way to deal with the question of food cross-reaction is probably to adopt a strict and conservative approach initially, when you are first working out what you react to. On an elimination diet (or on a rotation diet, if this is advised), start by being careful about the food families, and then relax gradually in order to find out what you can tolerate. You may not need to observe the families at all eventually. (For full advice on planning diets, a full list of food families.
Some foods contain moulds and can cause cross-reaction. Oils and terpenes in foods can also cause cross-reaction. Some foods cross-react with pollen.
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ALLERGY TO CLEANING PRODUCTS: WHAT CAUSES PROBLEMS?
Certain chemicals in cleaning products often cause sensitivity and allergy. Chlorine, ammonia and phenol are released from common bleaches, disinfectants and cleaners and can cause reactions if inhaled or touched. Fragrances and perfumes are added to virtually all cleaning products, either to add a pleasant fragrance, or as a masking chemical to block strong odours. Many products contain organic solvents, either used directly as cleaning agents, as in stain removers or dry cleaning fluid, or as solvents to carry other chemicals, as in polishes. Natural chemicals are not automatically safer. Some people are sensitive to chemicals, such as pine oil, coconut lemon oil, acetic acid (vinegar) and lavender oil, which are used in some cleaners. Nor are ‘green’ or environmentally safer products necessarily less likely to cause reactions. Most contain perfumes and some contain troublesome natural chemicals.
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ALLERGY BABYCARE: IF YOUR BABY IS TOTALLY BOTTLEFED
If your baby is totally bottiefed, make sure you have taken basic precautions against other things that the baby may be ingesting before you investigate its feed.
If your baby is on a cow’s milk formula feed, the first thing to try is giving smaller, more frequent feeds. This may help babies who are intolerant of lactose, the sugar found in milk, for the reasons explained on page 250 in connection with breastfeeding.
If this does not work, you can try alternative formula milks, with your doctor’s advice. Soya-based milks (e.g. Wysoy, Nutrition Soya) are most people’s first option; these are readily available in chemists’ shops, and are sometimes a good solution for babies sensitive to cow’s milk. Use a soya milk formula for at least a week to see if your baby settles – if he or she is clearly worse straightaway, see your doctor at once – but if the baby has been having colic, diarrhoea, or other gut disturbance, it can take a couple of weeks for these symptoms to clear.
Some babies also start to react to soya formulas, either straightaway or after some time. If this happens, there are other special formula milks that you can try. These are available on a doctor’s prescription. One type is based on chicken, highly processed to make it digestible (e.g. Chix). Another type is called hydrolysed formula, and is based on cow’s milk and corn, treated with digestive enzymes in order to break down and pre-digest allergens. Examples of these are Pregestimil and Nutramigin. These are sometimes tolerated by even highly allergic babies.
If you have a lot of problems with bottle-feeding, it is worth working your way through these alternative formulas, as one may suit where others do not. Each time you try a new one, give it a week to show effects if you can, unless the baby reacts strongly against it early on. Consult your doctor as you try each one.
A goat’s milk formula milk for babies has recently been introduced in the UK. There is no current evidence that it is of benefit to babies sensitive to other milks. Do not use it without consulting a doctor.
Other so-called hypoallergenic brands of cow’s milk formula are soon to be marketed in the UK. Hypoallergenic does not mean they are ‘safe’, only that cow’s milk allergens have been modified to make them better tolerated. These may not be tolerated by extremely allergic babies and have been known in the United States to cause anaphylactic (shock) reactions. Always consult your doctor before using any of these to be sure it is advisable for your baby. Only use them on prescription and under supervision. Do not buy over the counter.
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HOUSE DUST MITES ALLERGY: DRAWBACKS AND BENEFITS OF ANTI-DUST TREATMENTS
Apart from the need for follow-up vacuuming, the major disadvantage of chemical products is the need to re-apply (recommended between fortnightly and every six months, depending on make, except for the anti-mite paint) and the consequent cost. The cost of re-applying the treatments runs at somewhere between £100-£200 a year, depending on how extensively you do it, and on which chemical you use. You could pay for an increase in your heating bills to keep things dry, several vacuum filters or a large share of an allergy vacuum cleaner with the same amount of money. You can treat soft toys with sprays, but being often an awkward shape, the treatment does not always reach every part of the surface. If you treat furniture and mattresses, make sure they dry off thoroughly. Light or delicate fabrics can stain.
The nitrogen gas treatment is done by a contractor but is expensive, needs follow-up vacuuming, and has to be repeated frequently if you take no other precautions. It could be useful if you moved into a new home and wanted a once-off treatment to get rid of mites, then followed it up with basic avoidance measures.
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SEALING LEAKY VEINS SABOTAGE ERECTION
As you know, a man with leaky veins can find his erection sabotaged with amazing and disheartening efficiency. Until recently, leaky veins have been largely ignored by the medical profession, but now surgical solutions to this problem are receiving increased attention. One solution is to surgically tie off or remove the leaky veins, thus removing the source of the problem.
Belgian doctors have demonstrated just how effective vein surgery can be on certain patients. Out of 80 patients with potency problems, 20 were found to have impressive vein leaks.
Significantly, the leak involved the deep dorsal vein, a major source of blood flow out of the penis. The surgeons tied off the vein. Results were dramatic: 16 men found themselves with enough restored potency to allow intercourse. The 4 men who didn’t benefit from such improvement were found to have serious artery problems.
The best candidate for vein surgery has only his veins to blame for his potency difficulty; his arteries and nerves are normal. Usually the surgeon will make an incision somewhere on the penis, find the offending veins (which have previously been identified by a type of X-ray) and remove or tie them off, thus preventing them from carrying blood out of the penis. At the time of surgery the doctor can actually measure the extent of the leak by infusing fluid into the penis and measuring how fast it leaves. This way, he can gauge when enough veins have been tied off. Depending on where the veins are located, the procedure can be major or relatively minor surgery.
Unfortunately, no one knows how likely it is that a man with some leaky veins will develop others at some future time. Nevertheless, vein surgery holds the promise of a real advance in the treatment of some potency problems, making implants less necessary for some men.
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IMPOTENCE: THE DRUG MOST COMMONLY USED FOR THE SHOT
The drug most commonly used for the shot is papaverine, either by itself or in combination with another medication, phentolamine. The shot causes the arteries and sinuses to relax and allows increased blood flow into the penis. In some men, in fact, the blood flow produced by these shots may be somewhat greater than that which occurs during usual erections. Consequently, men whose nerves and blood vessels don’t work properly may be able to get an erection from a shot. After the shot, a small amount of pressure on the injection site is necessary to prevent bleeding.
If the shot works, results can be dramatic. In just a few minutes, a man who has had potency problems for years may find himself fully erect—and very happy. Jerry, a 50-year-old construction worker, had been unable to get an erection for ten years, ever since he fell on the job and suffered a painful and serious back injury. Jerry considered himself lucky to have recovered enough from the accident to be able to walk, but his potency did not return.
Jerry came to see a urologist, hoping that something new would be able to help his sex life. He had never heard about the shots, but was eager to try them. The first shot produced an erection—which surprised and pleased Jerry and his wife. The shots confirmed the doctor’s belief that Jerry’s erection problems were caused by nerves damaged in the fall. The shot, in effect, opened up the arteries and did the job the nerves were supposed to do. Subsequent shots resulted in the same reaction. After a decade without intercourse, this couple’s dry spell was over, Jerry ended up using the shots for regular treatment.
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AVOIDING ED AS A SIDE EFFECT: TAKING A DRUG “HOLIDAY”
Many of my patients who take antidepressant medications have adapted their sex lives to their use—a three-day medicine-free schedule, for example. Kirk was one such person. The thirty-eight-year-old, who had been under treatment for depression for several years, was overjoyed when he found that the regimen worked for him. “This is a
ED. The next step was to reintroduce the daily dose, but at lower levels terrific compromise,” he told me. “My depression is under control with Zoloft and I can enjoy my weekends. Life is good.”
I began using this alternative therapy after I read an intriguing 1995 study in the American Journal of Psychiatry by Dr. Anthony Rothschild. In his small sampling, Dr. Rothschild instructed the men to discontinue their SSRI drugs after their Thursday morning dose and restart them, at the same dosage, the following Sunday afternoon. After four weekends, Rothschild noted that there were no significant changes in the depression levels of those men who took the mini-drug vacations. However, there was definite improvement in both sexual functioning and satisfaction levels. According to him, antidepressant drug holidays worked best with men taking Paxil and Zoloft.
Note: Drug-free “holidays” are limited to non-life-threatening conditions where this option will work without risk to the patient. Discontinuing a beta-blocker, blood pressure medication, or diabetes drug can cause serious complications. If you take daily medication to manage conditions like hypertension, cardiovascular disorders, or asthma, don’t stop. Your most important job is to successfully treat your primary condition. Not taking a drug—even for a day—in order to achieve an erection is extremely dangerous to your health.
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ERECTION PROBLEMS: MULTIPLE SCLEROSIS (MS)
This disease, which seems to favor younger people as its victims, makes the nervous system degenerate. Small lesions attack the spinal cord and the brain and other parts of the nervous system which are essential to erection. Some male MS patients completely lose the ability to get an erection. Sometimes, men with MS can get erections, but they disappear before they can be enjoyed. Also, men with MS may find they can’t ejaculate, and for some, sexual desire also decreases or disappears. In some men, the disease causes numbness in the penis. Some researchers think that only one in four male MS patients develops erection problems from the disease; others think almost half of them do.
Sometimes, erection problems go hand-in-hand with other signs of the disease; at other times impotence is the first sign that something is wrong. For example, Brian, an engineer, was 43 years old when he first noticed a change. “I was unable to get an erection, even with candlelight, wine, a romantic setting, the whole bit. Sometimes it just wasn’t there. “Over a period of three years this distressing condition went from being an occasional problem to a chronic one.
At first, Brian couldn’t figure out what was wrong. He was filled with fear. “I just got very paranoid and embarrassed. I was afraid there was something wrong with me. I couldn’t tell anyone about it, except my wife. But mostly we avoided the subject. And I avoided being intimate with her. She knew that failure would just depress me more.”
After several months, Brian noticed he had problems walking. “I got very weak and collapsed. Finally I went to a doctor who suspected MS and confirmed the diagnosis. Actually, I felt relief at just knowing what was wrong.”
Brian was faced with the enormous challenge of coping and adjusting to the debilitating changes that go along with MS. But, although Brian made it plain to his doctors for several years that he also wanted help with his erection problem, he didn’t receive any, The doctors he consulted did not seem eager to deal with the issue. “Their attitude seemed to be ‘Sorry about that, Jack, the impotence is just a side effect of MS.’”
Luckily, Brian found out about penile implants and was able to have the operation. Although the MS has taken its toll, Brian is glad that once again, at least sometimes, he can make love with his wife.
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SEX AFTER THE MARRIAGE
During most of their marriage, William and Sharon have enjoyed sex together. But lately Sharon has wanted some changes in the bedroom. She’s been reading books about women’s sexual fulfillment, and wants her husband to read them—and try some of the suggestions. But William finds it difficult to read or talk about sex. Like many people his age, he received virtually no sex education as a child, and although he takes pride in the fact that he’s overcome the puritanical aspects of his background, the subject of sex still makes him uncomfortable. He secretly believes that sex shouldn’t be talked about unless there’s a problem, so if Sharon wants to talk, something must be wrong.
To make matters even more disturbing to William, what Sharon wants to talk about is orgasm. William “knows” that, as the man, he is supposed to “give” his wife an orgasm, and he fears that he has failed. And although he would deny it if asked, William has been influenced by what he sees in movies and on television: A “real” man is always ready to perform, eager for sex and able to satisfy any woman.
William believes he should always be ready to perform; his preoccupation with work, his health problems and his fatigue are irrelevant to this demand. These concerns just add to his anxiety and guilt. William is treating his body worse than one of the machines he designs—it’s never supposed to wear down, especially when it comes to sex, In William’s mind, the responsibility for fulfilling his desires, and his wife’s, rests squarely on him.
One Friday night, William comes home exhausted from a grueling day at the office and finds his wife taking a nap before dinner. He lies down beside her and falls asleep. When Sharon awakes, she wants to make love. As they cuddle and kiss, William gets excited, but a troubling conversation he had with his boss keeps popping into his mind. He loses his erection while making love and becomes embarrassed, angry and ashamed. He’s always been able to maintain an erection before. Sharon is clearly frustrated, although she tries to be understanding. She kisses him and murmurs a few words of encouragement. After a few minutes of lying quietly next to him, she asks him to please read the books on sex she has been mentioning for the last several weeks. William wants, more than anything, not to talk about his “failure.” He wants to escape into sleep, and he finally does.
During the next week, William and Sharon do not talk about what happened Friday night. But William thinks about it almost constantly and worries that it will happen again. He’s determined notto repeat his erection “failure.” So he plans a special night for the two of them.
The next Friday, William puts in a hard day at the office. He spends the morning feeling frustrated and angry over some problems at work, and to relieve his tension he smokes almost nonstop. In the afternoon he has a two-hour, unsatisfactory meeting with his boss, which just adds to his tension. Finally it’s time to leave, and William struggles to get home in rush-hour traffic. He barely has time to change his shirt before he and Sharon leave for dinner at theirfavorite restaurant. Atthe restaurant, William, worried about making love later, tries to relax with two martinis. Then, deciding it’s a special night and his diet doesn’t apply, he treats himself to a big steak with all the trimmings. After dinner the couple goes for a stroll. It’s after midnight by the time they get home.
By now, William has been looking forward for several hours to making love with his wife. Sharon undresses slowly, but William doesn’t waste anytime. Although it’s been a long day and he is tired, William has decided this is the night to make love, and he doesn’t want anything—even fatigue—to interfere. He strips and gets into bed. Lying there, he watches his wife get ready for bed, and feels himself becoming aroused. Sharon also has been anticipating the end of the evening. She is warm and willing, eager to have intercourse. William wants to make love, but he’s nervous, tired and afraid he will fail. His mind keeps returning to the last time, when he lost his erection. After several minutes of caressing his wife, he does not have an erection and begins to panic. Sharon is upset too. She asks if he still finds her attractive—what else could be the problem? William is tired, angry and discouraged. He snaps back that Sharon is not the problem, and stomps off to the kitchen, where he tries to console himself by drinking some Scotch.
Unfortunately, this isn’t an unusual example of sexual failure. It describes the experiences of many couples. Some overcome their problems in the early stages; others try to ignore the situation and find that their occasional difficulty turns into a chronic condition. It is important to realize that William set himself up for failure in a number of ways—many of them correctable. Here’s what’s wrong between William and Sharon, and how it could be set right.
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